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Case 11 Lower Genital UTI
Case 11 Lower Genital UTI
Case 11 Lower Genital UTI
Case 11
36 year old G4P4 (4004) complains of vulvar pruritus of one week duration. This is accompanied by foul yellowish
discharge. LMP: 2 weeks ago. External Genitalia: vulva edematous, erythematous with excoriations. Speculum
exam: (+) yellowish frothy discharge; Cervix erythematous with multiple pinpoint hemorrhages on the surface, IE:
Cervix long firm, closed. Uterus - normal sized, anteverted, movable; Adnexa no mass, no tenderness
Lower Genital Tract:
Vulva
External Genital organs of female
Labia majora, Labia minora, Urethral orifice, vaginal
introitus, perineum & anus
VULVAR INFECTIONS
Presentation:
Pruritis, Swelling, Erythema, Abscess
Lined by Stratified Squamous Epithelium that will
O
O
mean all of the Dermatologic lesions: 1 & 2 may
be presenting manifestations.
O
1 Skin Lesions: Macule, Patch, Papule, Plaque
O
2 Skin Lesions: Scale, Crust, Erosion, Fissure
It will be the knowledge of the particular disease that
will make enable you to make a diagnosis.
HERPES GENITALIS
3.
BARTHOLINS ABCESS
HERPES GENITALIS
2.
CONDYLOMA
CONDYLOMA ACUMINATA
4.
ULCERATIVE LESIONS
Difficult to diagnose looking similar to one another
Syphillis
Etiology: Treponema pallidum
Can differentiate depending on the stage:
Stage 1: Chancre (differentiate with chancroid)
Stage 2: Condyloma lata or latum
Stage 3: Gumma formation
Usually in Stage 2 is where youll able to dx it under
dark field illumination or culture of the spirochetes
Tx: Penicillin (Big dose)
Chancroid
Etiology: Haemophilus ducreyi
Both may look similar by inspection of the vulva, to be
sure, do diagnostic procedures.
Read on different ulcerations affecting the vulva:
Granuloma inguinale
Lymphogranuloma venereum
VAGINAL INFECTIONS
Vaginal infections will usually manifest as a form of an
abnormal vaginal discharge
Differentiate the color, odor & consistency - these
will be able to tell you what is the possible
pathogen
TRICHOMONAS VAGINITIS:
NOTE:
Read fungal & mycotic vaginatis, bacterial vaginosis,
atrophic vaginitis